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The impact of magnetic resonance in the preoperative staging and the surgical planning for treating small bowel neoplasms

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Abstract

Purpose

The role of MR enteroclysis/enterography (MRE) in the diagnosis of small bowel (SB) tumor has not been fully evaluated. The aims of this study were to assess the capability of MRE correctly identifying the site, stage and histology of such neoplasms.

Methods

MR enteroclysis/enterography was employed in consecutive patients suspected of having an SB tumor following negative upper and lower endoscopies. The SB was subdivided into proximal jejunum, middle SB and distal ileum. The histological examination (HE) of the surgical specimen was the reference standard.

Results

One hundred and fifty-eight patients were examined. Thirty-one out of 32 (96.9 %) SB detected by HE were correctly identified by MRE. The concordance rate between MRE and HE was 100 % for localization, and 87.1, 80.6 and 96.8 % for T, N and M stages, respectively. The concordance rate was 62.2 % for histological diagnosis.

Conclusions

The high concordance rates between MRE and HE for the localization of SB tumors and for their staging have a significant impact upon surgical planning, particularly if laparoscopy is being considered. A preoperative histological diagnosis is not sufficiently reliable.

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Conflict of interest

None of the authors have potentials or real conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, P. Stefanini, Policlinico Umberto I, La Sapienza, University of Rome, Via del Policlinico 155, 00191, Rome, Italy

    Giuseppe Pappalardo & Aldo Nunziale

  2. Radiology Emergency Department, Policlinico Umberto I, La Sapienza, University of Rome, Via del Policlinico 155, 00191, Rome, Italy

    GianFranco Gualdi, Gabriele Masselli & Emanuele Casciani

  3. Department of Oncology, “Mario Negri” Institute of Pharmacological Research, Via La Masa, 19, 20156, Milan, Italy

    Irene Floriani

Authors
  1. Giuseppe Pappalardo
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  2. GianFranco Gualdi
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  3. Aldo Nunziale
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  4. Gabriele Masselli
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  5. Irene Floriani
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  6. Emanuele Casciani
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Correspondence to Giuseppe Pappalardo.

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Pappalardo, G., Gualdi, G., Nunziale, A. et al. The impact of magnetic resonance in the preoperative staging and the surgical planning for treating small bowel neoplasms. Surg Today 43, 613–619 (2013). https://doi.org/10.1007/s00595-012-0270-1

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  • DOI: https://doi.org/10.1007/s00595-012-0270-1

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